About Us
Programs & Applications
Support Our Work
Opportunities
Partners & Advocates
Enrolled Families

Programs & Applications
 
  • The Programs
  • The Benefits
  • The Requirements
  • The Application
  • The Forms & Worksheets
  • Self-Employed Information
  • Frequently Asked Questions

    Return to Home
  • The Application

    The following applications can be downloaded and printed:

    English Application for Healthy Kids

    Spanish Application for Healthy Kids

    Renewal Application
    Use this application for the yearly renewal of your child’s health coverage

    Renewal Application - Spanish Version
    Use this application for the yearly renewal of your child’s health coverage

    If you would like to request an application be sent to you, please click here.

    If you need help filling out the application there are many people who can help you.

    • Call our office to get help over the phone at 1-877-464-2447
    • Email apphelp@nhhealthykids.com to get help with your application or to set up an appointment for help over the phone
    • Visit our office for help in person
      • Click for directions
    • Visit one of our application assistance sites for help in person
      • Call for a list of sites in your area (1-877-464-2447)

    The Application Steps:

    1. Fill out the application and sign it on the back
    2. Submit copies (not the originals) of all the documents listed on the checklist
    3. Mail the application to:

      NH Healthy Kids
      1 Pillsbury Street, Suite 300
      Concord, NH 03301

    If you are applying for Healthy Kids, click here for important new requirements effective October 1, 2008.